1. What is a vacuum device?
   The vacuum device is a treatment method for Erectile Dysfunction.
2. Who can use the Vacuum device?
   People with Erectile Dysfunction who do not prefer oral medication or are advised against taking PGE 5 inhibitors (Sildenafil, Tadalafil, Vardenafil, Udenafil)
   People with Erectile Dysfunction (ED) due to Diabetes, Depression, other Medical illnesses like surgery for prostate or colon cancer can be guided under sexologists. 
3. How does the vacuum device look?
   It is a small handy apparatus that consists of:
   (1) There is a cylinder to place over the penis.
   (2) There is a mechanism to create negative pressure.
   (3) A constriction ring/band is applied to the base of the penis to prevent the backflow of blood.
4. How to use a Vacuum Device?
   Ensure that the instrument you are using is FDA approved so that you will not harm your penis. Follow the manufacturer’s instructions and first see how the pump is creating suction and the penis is getting erect.Water-soluble jelly is applied to the base of the penis. This maneuver prevents air from seeping into the chamber, by creating a water-tight seal, thus maintaining the negative pressure within the cylinder. Some men may find that trimming the pubic hair may aid in achieving this water-tight seal.

   Place the cylinder over the penile shaft and hold firmly against the pubic bone. Use the pump either by hand or battery.

   Let the negative pressure develop slowly. This prevents penile pain due to too rapid a build-up of pressure within the cylinder. The negative pressure causes an inflow of blood into the corporal bodies, both arterial and venous in nature. The latter blood is drawn into the erectile chambers in a retrograde fashion.

   A constriction ring (band) must be applied to the base of the penis after the erection is achieved to act as an artificial valve, thus maintaining the blood within the corporal bodies. The rings come in a variety of shapes, sizes, and most importantly tension (tightness). Trial and error are used to define which ring size is most comfortable and efficient. 

   Most manufacturers suggest that the constriction ring remains in place for no longer than 30 minutes. Once the ring is in place the plastic cylinder can be removed and sexual relations may commence.

   That’s it. You are ready for sex.

5. How does a Vacuum Device work?
   Vacuum or negative pressure created over the penis mechanically brings powerful erection.
   A constriction band is applied at the base of the penis.
   The penis becomes hard and sexual intercourse can be done satisfactorily.
   Then remove the constriction band.
   The erection will disappear.
   Creating a vacuum is the opposite of what is done when the Doctor uses a sphygmomanometer, the blood pressure measuring analog device. For measuring Blood Pressure doctor pumps in to build pressure, whereas in Vacuum Device pumping creates negative pressure to suck blood in the penis.
   This pressure is approximately 200-250 mmHg.
   The surface temperature of the penis during the use of a vacuum device is 10°C lower than the temperature prior to the application of the device because of the constriction of blood vessels.
   The pump mechanism can be in the form of either a manually operated or a battery-operated system
   The battery-operated device can be used with one hand. In this system, the trigger mechanism is on the top end of the cylinder and thus one hand can activate the pump and steady the cylinder at the same time. This is an important consideration for patients with poor manual dexterity or strength, such as men with Parkinson’s disease or rheumatoid arthritis.Note: All FDA approved cylinders have pop-off valves, which limit the amount of pressure held within the chamber.

   
   

6. What not to fear?
   A black and blue mark or small area of bruising on the shaft of the penis. This is usually painless and generally will resolve in a few days.
   Semen will not spurt out. Ejaculation will be oozing of semen. When the constriction band is removed all semen leaks out. Pleasure or orgasm is the same. Does not harm sperms in the semen.
7. Who should not use a vacuum device?
   
   • Patients who have reduced sensation in their penis, as those who have spinal cord injury. They are at risk for trauma with repeated use of the constriction band. They should apply the ring for only short periods of time.
   • Men with a significant degree of curvature of the penis as those with Peyronie’s disease (acquired penile curvature) or congenital penile curvature. 
   • Medical conditions like:
     (i) Patients with hematologic forms of veno-occlusive priapism (sickle cell disease, thalassemia, or leukemia) should not use a vacuum device under any circumstances.
     (ii) Men who are using blood-thinners or have a history of bleeding disorders.
     (iii) Anticoagulant therapy may cause the patient to develop bruising and swelling in the penis due to the rupture of the superficial veins on the shaft of the penis (this can happen in normal men as well, but body repairs it) resulting from the constriction ring.

Note: It is often wise to take the treatment guided by a competent sexologist who has seen innumerable cases like yours. It is advisable to use it first under his guidance.

The average man using such a device will typically take 10-20 minutes to obtain a significant erection of penetration rigidity.

Warning:
If you fall prey to advertisements that claim to increase the size of the penis or to give superpower erection you may be buying something called a ‘penis developer’. Penis developers work with the same principle as a vacuum device but are not standardized for safety. Your penis is at risk of excessive pressure that can cause temporary or permanent damage. Often these devices can be obtained through mail order via the internet.